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SHOREHAVEN BEHAVIORAL HEALTH INC NPI 1891887055


NPI Information

NPI: 1891887055
Provider Name: SHOREHAVEN BEHAVIORAL HEALTH INC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
3900 W BROWN DEER RD
SUITE 200
BROWN DEER, WI
ZIP 53209
Phone: (414) 540-2170
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SHOREHAVEN BEHAVIORAL HEALTH INC is a clinical psychologist in Brown Deer, WI. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. SHOREHAVEN BEHAVIORAL HEALTH INC NPI is 1891887055. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3900 W BROWN DEER RD
SUITE 200
BROWN DEER, WI
ZIP 53209-220
Phone: (414) 540-2170
Fax: (414) 540-2171

The provider's authorized official is Don David Rosenberg .
The authorized official title is President and has the following contact phone number (414) 540-2170.

The enumeration date for this NPI number is 9/28/2006 and was last updated on 3/13/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselorNo
2101YA0400XCounselorAddiction (Substance Use Disorder)No
3101YP2500XCounselorProfessionalNo
4103G00000XClinical NeuropsychologistNo
5104100000XSocial WorkerNo
6106H00000XMarriage & Family TherapistNo
72084P0800XPsychiatry & NeurologyPsychiatryNo
82084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryNo
9221700000XArt TherapistNo
101041C0700XSocial WorkerClinicalNo
11103TC0700XPsychologistClinicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
142244721MEDICAIDWISCONSIN
242244700MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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